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Reviews in Cardiovascular Medicine Mar 2021Sudden cardiac death (SCD) is an unexpected sudden death due to a heart condition, that occurs within one hour of symptoms onset. SCD is a leading cause of death in... (Review)
Review
Sudden cardiac death (SCD) is an unexpected sudden death due to a heart condition, that occurs within one hour of symptoms onset. SCD is a leading cause of death in western countries, and is responsible for the majority of deaths from cardiovascular disease. Moreover, SCD accounts for mortality in approximately half of all coronary heart disease patients. Nevertheless, the recent advancements made in screening, prevention, treatment, and management of the underlying causes has decreased this number. In this article, we sought to review established and new modes of screening patients at risk for SCD, treatment and prevention of SCD, and the role of new technologies in the field. Further, we delineate the current epidemiologic trends and pathogenesis. In particular, we describe the advancement in molecular autopsy and genetic testing, the role of target temperature management, extracorporeal membrane oxygenation (ECMO), cardiopulmonary resuscitation (CPR), and transvenous and subcutaneous implantable cardioverter devices (ICDs).
Topics: Death, Sudden, Cardiac; Defibrillators, Implantable; Humans
PubMed: 33792256
DOI: 10.31083/j.rcm.2021.01.207 -
International Journal of Legal Medicine Mar 2021Sudden cardiac death (SCD) is one of the most common causes of death worldwide with a higher frequency especially in the young. Therefore, SCD is represented frequently... (Review)
Review
Sudden cardiac death (SCD) is one of the most common causes of death worldwide with a higher frequency especially in the young. Therefore, SCD is represented frequently in forensic autopsy practice, whereupon pathological findings in the heart can explain acute death. These pathological changes may not only include myocardial infarction, coronary thrombosis, or all forms of myocarditis/endocarditis but also rare diseases such as hereditary structural or arrythmogenic anomalies, lesions of the cardiac conduction system, or primary cardiac tumours.
Topics: Autopsy; Coronary Disease; Death, Sudden, Cardiac; Forensic Medicine; Humans; Molecular Diagnostic Techniques; Myocardial Infarction; Myocarditis
PubMed: 33349905
DOI: 10.1007/s00414-020-02481-z -
JACC. Heart Failure Jan 2018Sudden cardiac death is a tragedy at any age and under any circumstances but is perhaps most tragic when it claims the life of the athlete, the individual who... (Review)
Review
Sudden cardiac death is a tragedy at any age and under any circumstances but is perhaps most tragic when it claims the life of the athlete, the individual who epitomizes health and a healthy lifestyle. Sports cardiologists from around the world have worked to quantitate the incidence of sudden cardiac death (SCD) in the athlete, to identify risk factors, to develop pre-participation screening tools, and to formulate plans to deal with on-field SCD. Progress has been made, but much remains to be done in order to make both competitive and recreational sports safer for both patients with known cardiac disease and athletes without known or suspected cardiac abnormalities.
Topics: Athletes; Death, Sudden, Cardiac; Global Health; Heart Diseases; Humans; Incidence; Risk Factors; Survival Rate
PubMed: 29284578
DOI: 10.1016/j.jchf.2017.07.014 -
Medicina (Kaunas, Lithuania) Feb 2021Sudden cardiac death in athletes is a relatively rare event, but due to the increasing number of individuals practicing high-performance sports, in absolute terms, it... (Review)
Review
Sudden cardiac death in athletes is a relatively rare event, but due to the increasing number of individuals practicing high-performance sports, in absolute terms, it has become an important issue to be addressed. Since etiologies are many and the occurrence is rare, tracing the ideal preparticipation screening program is challenging. So far, as screening tools, a comprehensive clinical evaluation and a simple 12-lead electrocardiogram (ECG) seem to be the most cost-effective strategy. Recent technological advances came to significantly help as second-line investigation tools, especially the cardiac magnetic resonance, which allows for a more detailed ventricular evaluation, cardiac tissue characterization, and eliminates the poor acoustic window problem. This article aims to review all aspects related to sudden cardiac death in athletes, beginning with definitions and epidemiology, passing through etiology and clinical characteristics, then finishing with a discussion about the best ambulatory investigational approach.
Topics: Athletes; Death, Sudden, Cardiac; Electrocardiography; Humans; Mass Screening
PubMed: 33673000
DOI: 10.3390/medicina57020168 -
Clinics in Sports Medicine Jul 2022Sudden cardiac death (SCD) is the leading cause of medical death in athletes; however, many studies are significantly flawed making an accurate estimation of risk... (Review)
Review
Sudden cardiac death (SCD) is the leading cause of medical death in athletes; however, many studies are significantly flawed making an accurate estimation of risk difficult. Incidence studies need to have accurate case ascertainment, a defined study population, and should be stratified by both sex and age. The risk of SCA/d in college-aged males is 1 in 35,000 person-years, black males 1 in 18,000 person-years, and higher-risk sports include men's basketball, men's soccer, and American football. Inherited cardiomyopathies and electrical conditions account for ∼ 2/3 of off SCA/d and can be detected with an ECG. More research is needed to provide more granular estimates.
Topics: Humans; Male; Young Adult; Athletes; Death, Sudden, Cardiac; Football; Incidence; Universities; Soccer
PubMed: 35710267
DOI: 10.1016/j.csm.2022.02.002 -
Journal of the American College of... Jan 2024Athletes epitomize the healthiest segment of society. Despite this premise, sudden cardiac death may occur in apparently healthy athletes, attracting significant... (Review)
Review
Athletes epitomize the healthiest segment of society. Despite this premise, sudden cardiac death may occur in apparently healthy athletes, attracting significant attention not only in the medical community but also in laypersons and media. The incidence of sudden cardiac death is variably reported, and epidemiological burden differs among cohorts. Athletes appear to be at risk of developing fatal arrhythmias when harboring a quiescent cardiac disorder. Primary cardiomyopathies, ion channelopathies, and coronary artery anomalies are prevalent causes in young individuals. Cardiac assessment of athletes can be challenging because these individuals exhibit a plethora of electrical, structural, and functional physiological changes that overlap with cardiac pathology. A diagnosis of cardiac disease in a young athlete is not necessarily an indication to terminate competition and sports participation. International guidelines, traditionally focused on disqualification of individuals with cardiac disease, have recently adopted a more liberal attitude, based on a careful assessment of the risk and on a shared-decision making approach.
Topics: Humans; Death, Sudden, Cardiac; Heart Diseases; Athletes; Heart; Sports
PubMed: 38199713
DOI: 10.1016/j.jacc.2023.10.032 -
Current Problems in Cardiology Apr 2015Sudden death accounts for 300,000-400,000 deaths annually in the United States. Most sudden deaths are cardiac, and most sudden cardiac deaths are related to arrhythmias... (Review)
Review
Sudden death accounts for 300,000-400,000 deaths annually in the United States. Most sudden deaths are cardiac, and most sudden cardiac deaths are related to arrhythmias secondary to structural heart disease or primary electrical abnormalities of the heart. The most common structural disease leading to sudden death is ischemic heart disease. Nonischemic cardiomyopathy and other structural abnormalities such as arrhythmogenic ventricular dysplasia and hypertrophic cardiomyopathy may also be causative. Patients without structural disease have a primary electrical abnormality, such as long-QT syndrome or Brugada syndrome. Severe left ventricular systolic dysfunction is the main marker for sudden death in patients with ischemic or nonischemic cardiomyopathy. In other conditions, other markers for structural heart disease and electrical abnormalities need to be considered. It is seen that β-blocker therapy is associated with a reduction in sudden cardiac death across a broad range of disorders. Nevertheless, the implantable cardioverter defibrillator remains the most effective treatment strategy in selected patients.
Topics: Arrhythmias, Cardiac; Death, Sudden, Cardiac; Defibrillators, Implantable; Female; Heart Defects, Congenital; Humans; Myocardial Ischemia; Nervous System Diseases; Pregnancy; Pregnancy Complications, Cardiovascular; Risk Factors; Sports Medicine
PubMed: 25813838
DOI: 10.1016/j.cpcardiol.2015.01.002 -
Internal Medicine Journal Jul 2019Sudden cardiac death (SCD) is a devastating and all too common result of both acquired and genetic heart diseases. The profound sadness endured by families is compounded... (Review)
Review
Sudden cardiac death (SCD) is a devastating and all too common result of both acquired and genetic heart diseases. The profound sadness endured by families is compounded by the risk many of these deaths confer upon surviving relatives. For those with known cardiac disease, disease-specific therapy and risk stratification are key to reducing sudden death. For families of a SCD victim, uncovering a definitive cause of death can help relieve the agonising uncertainty and is a vital first step in screening surviving relatives and instituting therapy to reduce SCD risk. Increasing knowledge about the molecular mechanisms and genetic drivers of malignant arrhythmias in the diverse clinical entities that can cause SCD is vital if we are to optimise risk stratification and personalise patient care. Advances in diagnostic tools, disease-specific therapy and defibrillator technology are improving outcomes for patients and their families but there is still much progress to be made.
Topics: Death, Sudden, Cardiac; Heart Diseases; Humans; Risk Factors
PubMed: 31295785
DOI: 10.1111/imj.14359 -
Biomedical Papers of the Medical... Sep 2022Sudden cardiac death (SCD) is a major medical, economic and social problem. The estimated annual number of SCDs is approximately 4 million cases worldwide. Approximately... (Review)
Review
Sudden cardiac death (SCD) is a major medical, economic and social problem. The estimated annual number of SCDs is approximately 4 million cases worldwide. Approximately 50% of SCDs are unexpected first manifestations of cardiac disease. The survival rate after out-of-hospital cardiac arrest is low even in countries with the most advanced health care systems. It all emphasizes the importance of prevention, in which implantable cardioverter-defibrillators play a dominant role. However, our ability to recognize high-risk patients remains insufficient. Moreover, a declining rate of shockable rhythm as the initial recording has been reported in the last decades. Despite numerous SCD studies and undisputed progress, there are still many unanswered questions.
Topics: Death, Sudden, Cardiac; Defibrillators, Implantable; Humans; Out-of-Hospital Cardiac Arrest; Survival Rate
PubMed: 34782798
DOI: 10.5507/bp.2021.065 -
Emergency Medicine Clinics of North... Nov 2022Sudden cardiac death (SCD) describes the unexpected natural death from a cardiac cause within a short time period, generally 1 hour or lesser from the onset of... (Review)
Review
Sudden cardiac death (SCD) describes the unexpected natural death from a cardiac cause within a short time period, generally 1 hour or lesser from the onset of symptoms, often due to a cardiac dysrhythmia. Overall, the most common cause of SCD is coronary artery disease but for patients aged younger than 35 years, the most common cause of SCD is a dysrhythmia in the setting of a structurally normal heart. This article will review the background, diagnosis, and management of the common hereditary channelopathies and cardiomyopathies associated with an increased risk of SCD in patients without ischemic heart disease.
Topics: Humans; Aged; Syndrome; Death, Sudden, Cardiac; Arrhythmias, Cardiac; Cardiomyopathies
PubMed: 36396213
DOI: 10.1016/j.emc.2022.06.005